Rahma Center Quran Institute Registration Form - Session 4
Thank you for your interest in enrolling your child in Rahma Center's Quran Institute. Quran classes are offered onsite on Mondays & Wednesdays OR Tuesdays & Thursdays. Classes in the 2025-2026 academic year will begin in the week of August 18, 2025, until the week of May 28, 2026.
Please read the following information before proceeding. Enrollment Policy: Complete this registration form for each student to be enrolled between the ages of 6 to 15 years. The fees include $50 for registration, $50 for supplies and a monthly tuition of $200 per student. Monthly tuition of $200 is due by the 3rd day of each month. Please note that information for tuition assistance can be found in the Tuition, Registration & Supplies Payment section. All fees paid to RC are non-refundable. In the event of a cancellation, you may request that your payment be converted to a tax-deductible donation. Rahma Center reserves the right to disenroll students at its discretion. Release and Waiver of Liability (https://therahmacenter.org/releaseandwaiver/).
Student's Full Name
*
Student's Gender
*
Male
Female
Student's Birthdate
*
-
Month
-
Day
Year
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What grade is the student in for the 2025-2026 school year?
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Sixth grade
Seventh - Tenth grade
Parent's First Name
*
Parent's Last Name
*
Parent's Phone Number
*
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Parent's Email Address
*
example@example.com
Relationship to Student
*
Mother
Father
Home Street Address
*
Home City
*
Home Zipcode
*
Emergency Contact Full Name
*
Emergency Contact Phone Number
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Emergency Contact Email Address
*
Emergency Contact Email Address
*
example@example.com
Relationship to Student
*
Mother
Father
Is the Person Listed as the Emergency Contact Allowed to Pick up/Drop off the Student?
*
Yes
No
Other Individual Allowed to Pick up/Drop off the Student
Other Individual's Phone Number
Other Individual's Phone Number
Please enter a valid phone number.
Relationship to Student
Mother
Father
Other
Session Days
*
Tuesdays & Thursdays
Session Time:
*
5:40 PM - 7:15 PM
Release and Waiver of Liability (https://therahmacenter.org/releaseandwaiver/)
*
I agree to the terms of the Release and Waiver of Liability
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Tuition, Registration & Supplies Payment
Are you in need of financial aid? [Please note that you will need to submit the full payment and any fee adjustments will be made upon application approval. Please contact the office for more details at office@therahmacenter.org or (949)989-2351].
Yes
No
Payment Amount
*
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USD
QI
Payment Methods
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